ZMR-30192-05556

4 vaccinations 5 coded responses 38 check-ins 5 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 955 / CA
Registered: 2021-04-08

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-24
Dose 1 — Moderna
2021-04-08
Registered in v-safe
2021-04-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-04-29
Dose 2 — Moderna
2021-04-29
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · None · Be unable to do your normal daily activities

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia, Lymphadenopathy, Pain in extremity — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pain and swelling in my arm kept me up all night- no sleep.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-04
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I thought I was over the reaction because my arm doesnt bother me anymore, but I became exhausted very quickly when I tried to go back to normal activities.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Rash, Rash erythematous, Vaccination site pain, Vaccination site rash — Feeling: Poor · Site: Pain, Redness, Itching · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Forgot to mention I had a round red rash on either cheek on my face for 3 days. It is gone now. I was feeling better this morning so I did some gardening chores. Now the rash and pain at the vaccination area has returned and I am fatigued again.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 7, dose 2
Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness

Adult check-in
2021-05-13
Survey response — day 14, dose 2
MedDRA: Emergency care, Fatigue, Tooth abscess — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Abcessed infection in my tooth. Fatigue. · Healthcare visit (other): Emergency dental appointment.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-22
Dose 3 — Moderna
2021-08-22
Health check-in — day 0, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-08-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-08-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-08-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-08-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-08-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-09-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-09-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-09-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-09-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-02-20
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-03-22
Dose 4 — Moderna
2022-04-14
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-18
Call 1 — Left Voicemail
2022-04-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-04-26
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-05
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-21
Survey response — 3 months, dose 4
MedDRA: Fatigue, Tooth infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Tooth infection, very tired all the time.

MedDRA releases: 2024-11 · check-in free text available
2022-06-21
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-22
Call 2 — Left Voicemail
2022-06-22
Call 1 — Left Voicemail
2023-03-22
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna
2	2021-04-29	Moderna
3	2021-08-22	Moderna	No
4	2022-03-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-13	Unsuccessful
2022-06-21	Unsuccessful

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-01

Systemic reaction (other): Pain and swelling in my arm kept me up all night- no sleep.

2021-05-04

Systemic reaction (other): I thought I was over the reaction because my arm doesnt bother me anymore, but I became exhausted very quickly when I tried to go back to normal activities.

2021-05-05

Systemic reaction (other): Forgot to mention I had a round red rash on either cheek on my face for 3 days. It is gone now. I was feeling better this morning so I did some gardening chores. Now the rash and pain at the vaccination area has returned and I am fatigued again.

Release 8 — day 14, dose 2

2021-05-13

Symptoms: Abcessed infection in my tooth. Fatigue.

Healthcare visit (other): Emergency dental appointment.

Release 12 — 3 months, dose 4

2022-06-21

Symptoms: Tooth infection, very tired all the time.

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Emergency care	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Tooth abscess	✓	✓	✓
SD	Tooth infection	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Vaccination site pain	✓	✓	✓
SRO	Vaccination site rash	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release